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Effect of Surgical Therapy of Sleep Apnea Syndrom in Patient Treated by Noninvasive Ventilation
Kalhous, Jiří ; Čelakovský, Petr (advisor) ; Klozar, Jan (referee) ; Smilek, Pavel (referee)
Effect of Surgical Therapy of Sleep Apnea Syndrom in Patient Treated by Noninvasive Ventilation MUDr. Jiří Kalhous The method of choice in patients with sleep apnea syndrome is Positive Airway Pressure (PAP - CPAP / BPAP), surgical intervention is usually a last resort. Some patients with PAP, who are treated suboptimally, may also benefit from concomitant surgery. Material and methods: The study included 25 patients with severe obstructive sleep apnea syndrome (age 17-72, baseline AHI 31-120, av. 66, baseline pressure on PAP 8-20 mbar) who were indicated for PAP therapy and whose treatment for various reasons was suboptimal. All patients underwent oropharyngeal surgery (tonsillectomy, uvulopalatopharyngoplasty, radiofreqsuency-assisted uvuloplasty, or a combination thereof). Two months after the operation, a controlled limited polygraphy and off-line retitration of the ventilation device were performed. Monitored parameters: 1. subjective difficulties, preventing further use of PAP treatment. 2. AHI, ODI, T90 before and after surgery. 3. The level of pressure on the PAP device before and after surgery. Results: 1. None of the patients in our group had problems preventing further use of the ventilation device. 2. In our group of study there was a statistically significant reduction AHI after surgery...
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The time factor in radical radiotherapy of head and neck tumours
Lohynská, Radka ; Stankušová, Hana (advisor) ; Klozar, Jan (referee) ; Feltl, David (referee) ; Odrážka, Karel (referee)
The impact of waiting time and overall treatment time on locoregional control and survival in normofractionated radical radiotherapy for squamous cell head and neck cancer was evaluated. There is evidence for decreased locoregional control of missed radiotherapy treatment days (one week prolongation amounts for 7-10% loss of local control). There are three main compensation methods for treatment gaps (1. weekend treatment days and two fractions per day to catch up; 2. retain overall treatment time and increase dose per fraction; 3. accept protraction and give extra fraction to compensate for gap). Powered by TCPDF (www.tcpdf.org)
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Application and Testing of Effectiveness of the Internet in Professional Football Clubs Marketing
Klozar, Jan ; Čáslavová, Eva (advisor) ; Navrátilová, Miroslava (referee)
Název: Využití a ověření účinnosti internetu v marketingu profesionálních fotbalových klubů Název v angličtině: Application and testing of the effectiveness ofthe internet in the marketing area ofprofessional football clubs Cíle práce: Analýza současného stavu využívání internetu v marketingu profesionálních fotbalových klubů a následné zpracování doporučení pro české kluby, jak lépe internet v marketingu využívat. Metody: Práce byla vypracována na základě popisné a komparativní analýzy, analýzy SWOT a dotazm'ku. Výsledky: Práce popsala současnou situaci ve využívání internetu v marketingu českých fotbalových klubů. Tato situace byla nejprve porovnána se stavem využívání internetu zahraničními kluby. Následně byly zpracovány názory uživatelů internetu na oficiální stránky českých klubů získané z provedeného průzkumu. Z výsledků porovnání zahraničních stránek a názorů respondentů vyplynulo doporučení optimálru'ho zpracování využívání internetu pro tuzemské kluby. Klíčová slova: marketing, internet, marketingový mix, internet a marketing, popisná analýza, komparativní analýza, analýza SWOT, fotbal, profesionální kluby JanKlozar 31.3..2006 2
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Epidemiological and immunological aspects of HPV etiology of head and neck cancers
Maléřová, Simona ; Klozar, Jan (advisor) ; Salzman, Richard (referee) ; Zámečník, Josef (referee)
The incidence of human papillomavirus (HPV) -associated oropharyngeal tumors is steadily increasing therefore, information about the prevalence of oral HPV and its risk factors is very important for future screening and early diagnosis of the disease. This thesis addresses three topics. The first topic is to evaluate the prevalence of oral HPV in a healthy population and to investigate risk factors for oral HPV infection, given that these data are almost completely absent in Central Europe. A statistically significantly higher rate of positivity (8.8%) of oral HPV infection was found in the group of older unvaccinated probands than in younger partially vaccinated volunteers (2.0%). The seropositivity rate of anamnestic HPV antibodies was comparable in both groups. None of the analyzed risk factors were significantly associated with oral HPV positivity. The second topic of the thesis is the dynamics of HPV specific antibodies in patients with head and neck cancer and their prognostic significance. In patients with cervical cancer, a decrease in HPV E6 / E7-specific antibodies is associated with a better prognosis. Another goal of the dissertation was to assess the importance of anamnestic antibodies and antibodies against oncoproteins E6 and E7 in long-term follow-up 2-14 years after the end of...
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Immunoprofiling in patients with HPV-associated and non-associated head and neck squamous cell carcinoma
Lukešová, Eva ; Klozar, Jan (advisor) ; Šlapák, Ivo (referee) ; Laco, Jan (referee)
Head and neck squamous cell carcinomas (HNSCC) remain a significant cause of morbidity worldwide, with approximately 550,000 new cases diagnosed each year. The main etiological factors include smoking and alcohol consumption. The incidence of non-oropharyngeal HNSCC is gradually decreasing while the incidence of squamous cell oropharyngeal carcinoma (OPSCC) is still on the rise. This increasing incidence can be most likely attributed to an increasing prevalence of human papillomavirus (HPV) infection. From the clinical point of view the most significant fact is that patients with HPV positive OPSCC have better prognosis. HNSCC is linked to an alteration in the immune system. Only a limited number of studies have correlated both the immunological parameters and HPV status with patient prognosis. Therefore, we focused on the research of the immunological profile of patients with HNSCC of viral and non-viral etiology. In our study, 110 patients with HNSCC were enrolled. They were divided into HPV-positive and HPV-negative groups based on the expression of HPV 16 E6 mRNA detected in the tumor tissue. Basic lymphocyte subpopulations (CD3+, CD4+ CD25+ Treg, CD4+ CD25+ FoxP3 Treg, CD4+, CD8+, CD19, and CD3- CD16+ CD56+ cells) were determined by flow cytometry in the peripheral blood (PB). We observed...
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The role of human papillomavirus in the etiology and prognosis of squamous cell carcinoma of the oropharynx
Rotnáglová, Eliška ; Klozar, Jan (advisor) ; Šlapák, Ivo (referee) ; Zámečník, Josef (referee)
Tonsillar cancer (TC) presents an important part of head and neck cancers and its incidence is rising in the Czech Republic. Cigarette smoking and alcohol abuse are risk factors responsible for approximately two thirds of all head and neck cancers. Furthermore, a role of human papillomavirus (HPV) as an independent risk factor has been demonstrated recently. The aims of the present study were to find demographical differences between the group of HPV-positive and negative patients, to determine the prevalence of HPV in TC of Czech patients and also to find out whether the virus in HPV DNA positive tumors is transcriptionally active. Another aim was to test different markers of HPV infection for a precise selection of patients with HPV associated disease and to determine the prognostic role of these markers. A set of 109 patients with primary TC was examined for HPV DNA presence in tumor tissue and for the presence of HPV specific antibodies in serum. Data regarding risk factors were obtained by questionnaires. Forty-five samples were available for E6 and E2 mRNA analysis and for immunohistochemical analysis of p16 and p53 expression. The overall prevalence of HPV DNA in TC was 65%. In 93% of HPV16 DNA positive samples the virus was transcriptionally active. The E2 expression status has shown that in...
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Clinical aspects of human papillomavirus infection in diagnosis and treatment in patients with squamous cell carcinoma of the oral cavity and oropharynx
Košľabová, Eva ; Klozar, Jan (advisor) ; Pellant, Arnošt (referee) ; Zámečník, Josef (referee)
A studies carries for the last twenty years accumulated data that show two different etiology of head and neck squamous cell carcinoma. Tumors located in the oral cavity are often independent of the viral infection and is associated with tobacco and alcohol use. Approximately 26 % of all HNC and more than 50 % of tonsillar cancers are associated with the presence of high risk human papillomavirus (HR HPV). The purpose of this study was to determine whether changes in HPV DNA prevalence in oral rinses and/ or HPV - specific antibody levels in sera of patients with head and neck carcinoma (HNC) have prognostic significance. Patients with HNC were enrolled (N=142). The presence of HPV DNA was assayed in tumor tissue and oral rinses, and HPV-specific antibodies were assessed in sera. Sera were drawn one month and one year after the end of treatment. One year after treatment, oral rinses were collected. Altogether, 59.2 % tumors were HPV positive. Initially, the presence of HPV DNA in the tumors strongly correlated with HPV DNA positivity in oral rinses as well as with the presence of HPV- specific antibodies in sera. Out of 66 patients with HPV positive oral rinses at enrollment, 84.8 % became negative at one-year follow up. The mean titres of HPV 16 E6 and E7 antibodies at follow- up were lower in...
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Immunoprofiling in patients with HPV-associated and non-associated head and neck squamous cell carcinoma
Lukešová, Eva ; Klozar, Jan (advisor) ; Šlapák, Ivo (referee) ; Laco, Jan (referee)
Head and neck squamous cell carcinomas (HNSCC) remain a significant cause of morbidity worldwide, with approximately 550,000 new cases diagnosed each year. The main etiological factors include smoking and alcohol consumption. The incidence of non-oropharyngeal HNSCC is gradually decreasing while the incidence of squamous cell oropharyngeal carcinoma (OPSCC) is still on the rise. This increasing incidence can be most likely attributed to an increasing prevalence of human papillomavirus (HPV) infection. From the clinical point of view the most significant fact is that patients with HPV positive OPSCC have better prognosis. HNSCC is linked to an alteration in the immune system. Only a limited number of studies have correlated both the immunological parameters and HPV status with patient prognosis. Therefore, we focused on the research of the immunological profile of patients with HNSCC of viral and non-viral etiology. In our study, 110 patients with HNSCC were enrolled. They were divided into HPV-positive and HPV-negative groups based on the expression of HPV 16 E6 mRNA detected in the tumor tissue. Basic lymphocyte subpopulations (CD3+, CD4+ CD25+ Treg, CD4+ CD25+ FoxP3 Treg, CD4+, CD8+, CD19, and CD3- CD16+ CD56+ cells) were determined by flow cytometry in the peripheral blood (PB). We observed...
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The role of human papillomavirus in the etiology and prognosis of squamous cell carcinoma of the oropharynx
Rotnáglová, Eliška ; Klozar, Jan (advisor) ; Šlapák, Ivo (referee) ; Zámečník, Josef (referee)
Tonsillar cancer (TC) presents an important part of head and neck cancers and its incidence is rising in the Czech Republic. Cigarette smoking and alcohol abuse are risk factors responsible for approximately two thirds of all head and neck cancers. Furthermore, a role of human papillomavirus (HPV) as an independent risk factor has been demonstrated recently. The aims of the present study were to find demographical differences between the group of HPV-positive and negative patients, to determine the prevalence of HPV in TC of Czech patients and also to find out whether the virus in HPV DNA positive tumors is transcriptionally active. Another aim was to test different markers of HPV infection for a precise selection of patients with HPV associated disease and to determine the prognostic role of these markers. A set of 109 patients with primary TC was examined for HPV DNA presence in tumor tissue and for the presence of HPV specific antibodies in serum. Data regarding risk factors were obtained by questionnaires. Forty-five samples were available for E6 and E2 mRNA analysis and for immunohistochemical analysis of p16 and p53 expression. The overall prevalence of HPV DNA in TC was 65%. In 93% of HPV16 DNA positive samples the virus was transcriptionally active. The E2 expression status has shown that in...
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Radiochemotherapy with weekly cisplatin in the treatment of head and neck cancer
Pála, Miloslav ; Odrážka, Karel (advisor) ; Soumarová, Renata (referee) ; Klozar, Jan (referee)
Radiochemotherapy with weekly cisplatin in the treatment of head and neck cancer. Purpose: The objective of this study was to evaluate the feasibility, toxicity and efficacy of postoperative and definitive radiochemotherapy with weekly cisplatin in locoregionally advanced or high risk head and neck cancer. Material and methods: Patients with head and neck cancer of stage III-IVb or patients with insufficient margins of resection after initial surgery were included in the study of postoperative radiotherapy. Radiotherapy consisted of 70 Gy/ 7 weeks/ 35 fraction after R1/2 resection and 60- 64 Gy/ 6-6,5 weeks/ 30-32 fraction after R0 resection, respectively. Patients with head and neck cancer of stage II-IVb without initial resection were included in the study of definitive radiochemotherapy. Radiotherapy consisted of 70 Gy / 7 weeks / 35 fraction. All patients received concurrent cisplatin 40 mg/m2 weekly. Results: Postoperative radiochemotherapy: Between 6/2002 and 12/2008, 100 consecutive patients WHO 2, male to female ratio 84/16, median age 54 years were treated. Tumours of the oropharynx were the most frequent (49%) and stage IV was predominant (86%). 96% patients received the full radiation treatment as planned. Median total tumor dose was 66 Gy. Omission of weekly cisplatin had been...
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